I noticed a small cluster of red spots on the top of one foot about two days ago. Initially, I thought they were caused by friction from my Birkenstock straps, but after checking, I realized the spots don't actually align with either strap.
There were initially around four spots, possibly increasing to six. They became more prominent yesterday but haven't noticeably changed since. They're slightly raised to the touch, do not blanch with pressure, and are neither painful nor itchy.
For context, I have systemic lupus erythematosus (SLE) and a history of abnormal clotting-related bloodwork, including possible lupus anticoagulant abnormalities and low platelet counts. I also bruise unusually easily and sometimes develop large, dark bruises with little or no apparent trauma. Vasculitis has been raised as a possibility by specialists in the past, although a previous workup was negative.
I frequently develop petechiae from relatively minor pressure, such as carrying grocery bags or wearing a backpack, and occasionally notice them spontaneously on my chest and breasts.
I realize these spots could be something completely benign, like insect bites, but their non-blanching appearance, slight elevation, and my medical history have me wondering whether they warrant further investigation.
Does this look concerning for palpable purpura or cutaneous small-vessel vasculitis, or could it reasonably be something more benign? Is this worth getting evaluated promptly, or would monitoring for a few days be reasonable?
** photos *\* https://imgur.com/a/iZDzP9V
